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Routine Continuous Electrocardiographic Monitoring Following Percutaneous Coronary Interventions Effect of Aspirin on All-Cause Mortality in the Healthy Elderly Variation in Revascularization Practice and Outcomes in Asymptomatic Stable Ischemic Heart Disease Mode of Death in Heart Failure With Preserved Ejection Fraction Burden of 30-Day Readmissions After Percutaneous Coronary Intervention in 833,344 Patients in the United States: Predictors, Causes, and Cost Generalizing Intensive Blood Pressure Treatment to Adults With Diabetes Mellitus A Novel Familial Cardiac Arrhythmia Syndrome with Widespread ST-Segment Depression Select Drug-Drug Interactions With Direct Oral Anticoagulants Cardiovascular Biomarkers and Imaging in Older Adults: JACC Council Perspectives ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2019 Appropriate Use Criteria for Multimodality Imaging in the Assessment of Cardiac Structure and Function in Nonvalvular Heart Disease: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and the Society of Thoracic Surgeons

Review Article2017 Jun 13;69(23):2845-2861. ​

JOURNAL:J Am Coll Cardiol. Article Link

Left Ventricular Assist Devices for Lifelong Support

Pinney SP, Anyanwu AC, Lala A et al. Keywords: cardiothoracic surgery; heart failure; hemocompatibility

ABSTRACT


Continuous-flow left ventricular assist devices (LVADs) have revolutionized advanced heart failure care. These compact, fully implantable heart pumps are capable of providing meaningful increases in survival, functional capacity, and quality of life. Implantation volumes continue to grow, but several challenges remain to be overcome before LVADs will be considered as the therapy of choice for all patients with advanced heart failure. They must be able to consistently extend survival for the long term (7 to 10 years), rather than the midterm (3 to 5 years) more typical of contemporary devices; they must incorporate design elements that reduce shear stress and avoid stasis to reduce the frequent adverse events of bleeding, stroke, and pump thrombosis; and they must become more cost-effective. The advancements in engineering, implantation technique, and medical management detailed in this review will highlight the progress made toward achieving lifelong LVAD support and the challenges that remain.